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1. What is on the differential for a floor of mouth (FOM) swelling with thick
fluid?
A. Mucocele vs. lipoma
B. Ranula vs. dermoid cyst
C. Sialolith vs. abscess
D. Odontogenic keratocyst vs. ameloblastoma
Rationale: A ranula (mucus extravasation from the sublingual gland) and a
dermoid cyst both present as FOM masses with thick contents.
2. A buccally impacted canine most commonly indicates:
A. Excess palatal bone
B. Lack of arch space
C. A supernumerary tooth
D. Cleft palate
Rationale: Buccal impaction usually results from crowding, while palatal impaction
is more often linked to other causes.
3. What is #1 on the differential for a mixed (radiolucent-radiopaque) lesion in
the canine space?
A. Ameloblastoma
B. Odontogenic keratocyst
,C. Adenomatoid odontogenic tumor (AOT)
D. Central giant cell granuloma
Rationale: AOT classically occurs in the anterior maxilla around an impacted
canine in young patients.
4. Which maxillofacial lesion is likely to show giant cells on pathology?
A. Dentigerous cyst
B. Aneurysmal bone cyst
C. Simple bone cyst
D. Periapical cyst
Rationale: Aneurysmal bone cysts contain blood-filled spaces with multinucleated
giant cells.
5. What happens to the condyle in osteoarthritis?
A. Hyperplasia with lysis
B. Erosion with sclerosis
C. Complete resorption in all cases
D. Bony ankylosis only
Rationale: Degenerative joint disease produces surface erosion, subchondral
sclerosis, and osteophytes.
6. How is condylar sag prevented in an intraoral vertical ramus osteotomy
(IVRO)?
A. By rigid fixation
B. By releasing the lateral pterygoid
C. By preserving the medial pterygoid
D. By intermaxillary fixation for 8 weeks
Rationale: The intact medial pterygoid holds the proximal segment in position and
limits sag.
7. What is the purpose of a modified condylotomy?
,A. To correct a skeletal Class III
B. To remove the disc
C. To increase joint space in patients with internal derangement
D. To treat ankylosis
Rationale: Repositioning the condyle downward and forward unloads the joint and
helps disc recapture.
8. How does the modified condylotomy differ from IVRO during dissection?
A. IVRO releases the masseter
B. With a modified condylotomy, the medial pterygoid is released, whereas it is
preserved in an IVRO
C. Both release the medial pterygoid
D. Neither involves the pterygoid
Rationale: Release of the medial pterygoid allows the condyle to sag, which is the
goal of a modified condylotomy.
9. Where does the facial nerve enter most muscles of facial expression?
A. Along their superficial surface
B. At the origin only
C. On their deep surface
D. Through the tendon
Rationale: Most muscles are innervated from the deep surface (buccinator,
mentalis, and levator anguli oris are the exceptions).
10. Which local anesthetic has the lowest pKa (per source)?
A. Lidocaine
B. Bupivacaine
C. Prilocaine (per source)
D. Articaine
, Rationale: A lower pKa means more drug in the uncharged form at tissue pH,
giving faster onset. Many references list mepivacaine as the lowest, so check your
reference.
11. Which local anesthetic is long lasting, and why?
A. Lidocaine; low protein binding
B. Prilocaine; vasodilation
C. Bupivacaine; high protein binding
D. Articaine; high pKa
Rationale: High lipid solubility and protein binding keep bupivacaine at the nerve
longer.
12. Which receptor is responsible for respiratory depression from opioids (per
source)?
A. Kappa
B. Delta
C. Mu-1
D. Mu-2 (source says Mu-1; Mu-1 usually denotes analgesia)
Rationale: Mu-1 mediates analgesia, and Mu-2 mediates respiratory depression,
bradycardia, and dependence.
13. Which opioid is broken down by plasma esterases?
A. Fentanyl
B. Morphine
C. Remifentanil
D. Sufentanil
Rationale: Rapid ester hydrolysis gives remifentanil a very short, context-
insensitive half-life.
14. Where is articaine metabolized?
A. Only in the liver
B. In the kidney